Provider Demographics
NPI:1609355577
Name:ALAHAYDOIAN, JILLIAN A
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:A
Last Name:ALAHAYDOIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:JILLIAN
Other - Middle Name:A
Other - Last Name:ALAHAYDOIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:13900 HORIZON BLVD
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-6557
Mailing Address - Country:US
Mailing Address - Phone:915-206-6215
Mailing Address - Fax:915-206-6215
Practice Address - Street 1:13900 HORIZON BLVD
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-6557
Practice Address - Country:US
Practice Address - Phone:915-206-6215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61574183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist